FAQs about treatment

Treatment options and risks

• What are the risks involved in having fertility treatment?
• Why is there so much concern about having twins or triplets after fertility treatment?
• What is "in vitro maturation" and why might it be better for me than  'standard' IVF?
• Surgical sperm extraction has not worked for me.  Are there any other options?
• What is the procedure for transferring sperm, eggs or embryos from abroad?
• I'm worried that my cancer treatment means I won't be able to have children
• What should I do with unused medicines?
• My clinic has prescribed medicine for my treatment. Is there any restriction about where I can get the medicines from?

• I've used donated eggs/sperm in my IVF treatment.  How do I find out more about the donor?
• I may have to use donated eggs or sperm in my treatment - what are the rules about this?
• I am using donor sperm in my treatment.  Whose name goes on the birth certificate as the baby's father?
• I hear there's a shortage of sperm donors in the UK. Can I buy sperm from abroad?
• Can I use fresh sperm from internet websites? Is it legal? Is it safe?
• I´ve seen press reports saying that only anonymous sperm donors are exempt from being treated as the legal father - is this true? 
• Who is the legal father of a child born using unlicensed services?
• I know someone who is willing to donate sperm through a private arrangement with me (and/or my partner).  Who would be the legal father?

• I'd like to freeze my embryos for future use. What's involved?
• Where can I have sperm stored for future use?  
• I've heard that women can freeze their eggs to use later.  How do I go about doing this?

• How likely am I to get pregnant after IVF treatment?
• How many people have fertility treatment in the UK?
• When is the HFEA going to provide more recent success rates for clinics?

• What is reproductive immunology?
• I've had doubts about reproductive immunology (IVIG) treatment, but my clinic has recommended it.  What's the HFEA's view?
• I previously had reproductive immunology treatment and I'm worried about how this will affect me and my child(ren).

• Can I choose the sex of my child?
• What is PGD and who can have it? 

Treatment options and risks

What are the risks involved in having fertility treatment?
Like all medical treatment, having fertility treatment does carry some risks and your clinic should discuss these with you.  The main risks are adverse drug reactions and having a multiple birth.  There are also risks associated with pregnancy, whether through fertility treatment or natural conception, such as having an ectopic pregnancy. 

Read more information about risks.

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Why is there so much concern about having twins or triplets after fertility treatment?
Having a multiple birth (twins, triplets or more) is the single greatest health risk associated with fertility treatment.  This is why the HFEA has imposed restrictions on the number of embryos that can be transferred in IVF to a maximum of two for women under the age of 40 and a maximum of three for women aged 40 or over who are using their own eggs (if you are using donated eggs, the maximum is two).

Multiple births carry risks to both the health of the mother and to the health of the unborn babies.  Twins or triplets are more likely to be premature and to have a below-normal birth weight.  Studies show that the risk of death before birth, or within the first week of life, is more than four times greater for twins than for a single baby. For triplets, the risk is seven times greater than for a single baby.

For more information, visit Oneatatime.org.uk

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What is "in vitro maturation" and why might it be better for me than  'standard' IVF?
In vitro maturation (IVM) is a new technique whereby eggs are matured in the laboratory before being fertilised with sperm. Fertilisation is, therefore, still 'in vitro'. 
 
The difference between IVM and 'standard' IVF is that the eggs are immature when they are collected. This process means that the woman does not need to take as many drugs before the eggs can be collected as she might if using the 'standard' IVF process when mature eggs are collected. This means that this option could be particularly helpful to women who are more susceptible to developing ovarian hyper-stimulation syndrome (OHSS - see FAQ on risks of IVF), such as those with a polycistic ovarian syndrome.
 
IVM is still a relatively new technique and so far about 300 children have been born worldwide as a result. To date there is no evidence to suggest this treatment is unsafe, neither is there enough evidence to be absolutely certain of its safety. This is something you should discuss with your doctor before making a decision about your treatment. At present (January 2007), only one UK clinic is licensed to carry out this treatment.

Read more in our new factsheet Using in vitro matured eggs in treatment.

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Surgical sperm extraction has not worked for me.  Are there any other options?
If your doctors have been unable to extract any sperm, you will probably find the only option is to use donor sperm to fertilise your partner's eggs. Depending on a clinic's availability of donor sperm, it may be possible to use sperm from a donor who shares some of your physical characteristics. A clinic will only use donated sperm that has been screened for infections, such as hepatitis and HIV, which involves a quarantine period of around six months.
 
The donated sperm can then be used to fertilise your partner's eggs through a process called intrauterine insemination (IUI) or by in vitro fertilisation (IVF).  The donor will be identifiable, which means any child born as a result will have the right to ask for information about their donor when they reach adulthood, including the donor's name. 
 
For more about IUI, IVF and using donated sperm in treatment, order a copy of the HFEA Guide to Infertility.

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What is the procedure for transferring sperm, eggs or embryos from abroad?

From within the EU
If you are considering obtaining sperm, eggs or embryos from within the within the EU, the clinic will organise for a transfer to be made from that country.

The donations will need to meet the following criteria:

• The EU/EEA country from which the transfer is being made has implemented EU wide quality and standards known as the EU Tissues and Cells Directive (EUTCD).
• The clinic from which the transfer is being made is licensed or accredited under the laws of that EU country.
• The sperm, eggs or embryos transferred meet UK requirements on screening, as set out in HFEA licence conditions and the HFEA Code of Practice.
• The donor of the sperm, eggs or embryos:
  - is identifiable,
  - has consented to the transfer of their sperm, eggs or embryos to the UK and
  - has been made aware of the legal position in the UK on identifying donors (including the implications for the donor).
• The donor of the sperm, eggs or embryos must have only received reasonable expenses or reimbursement for loss of earnings. No inconvenience payments should have been made to the donor.

The UK clinic receiving the donation must make sure that the EU/EEA clinic providing the donation has met these criteria in order for the transfer to take place.

Outside the EU
If you are considering obtaining sperm, eggs or embryos from outside the EU, the clinic will need to apply to the HFEA for a Special Direction on your behalf to import from that country.

Clinics must demonstrate that the donation has met the following UK standards:

• The sperm, eggs or embryos transferred meet UK requirements on screening, as set out in HFEA licence conditions and the HFEA Code of Practice.
• The donor of the sperm, eggs or embryos:
  - is identifiable,
  - has consented to the transfer of their sperm, eggs or embryos to the UK and
  - has been made aware of the legal position in the UK on identifying donors (including the implications for the donor).
• The donor of the sperm, eggs or embryos must have only received reasonable expenses or reimbursement for loss of earnings. No inconvenience payments should have been made to the donor.

The application for a Special Direction will be considered by the HFEA Licence Committee, this could take between 3 - 6 weeks.

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I'm worried that my cancer treatment means I won't be able to have children
 Some cancer treatments can have an impact on future fertility, and it is worth discussing this with your doctor before your treatment begins.  Men can, for example, freeze their sperm and women can consider creating embryos with their partner (if they have one) or using donated sperm to create embryos which can be frozen and used later.  Visit the Cancerbackup website for more information about maintaining your fertility.

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I have unused medicines from my fertility treatment.  What should I do with them?
If you have drugs left over from your fertility treatment, you should return them to your clinic or to a pharmacy for proper disposal.

You cannot offer your drugs, either for sale or free, to another patient. The Medicines Act 1968 contains strict provisions about medicines and who can sell them. For more information about the laws governing the supply of medicines see NHS Direct.

The Medicines and Healthcare Products Regulatory Agency (MHRA) is the government agency responsible for ensuring that medicines and medical devices work, and are acceptably safe. For further information about the disposal of unwanted medicines see the MHRA website.

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My clinic has prescribed medicine for my treatment. Is there any restriction about where I can get the medicines from?
There are strict laws about medicines and who can sell them. For more information about the laws governing the supply of medicines see NHS Direct. For details of registered pharmacists see the Royal Pharmaceutical Society.

The Medicines and Healthcare Products Regulatory Agency (MHRA) has highlighted concerns about some websites that sell medicines. See the MHRA website for further information.

A doctor cannot tell you which pharmacist to use. The General Medical Council (GMC) has issued guidance to doctors on prescribing medicines called "Good Practice in Prescribing Medicines (2006)". In the section entitled "Doctors' interests in pharmacies" the guidance states that "Patients should be free to choose from which pharmacy to have their prescribed medicines dispensed" and "You must not pressurise patients to use a particular pharmacy in any event, either personally or through an agent". To find out more about this guidance, see the GMC website.

If you are unhappy with the way your clinic is prescribing medicines for you, you should in the first instance complain to the clinic.  If your complaint about prescribing is not resolved, then you should seek further advice from the Healthcare Commission or the General Medical Council.

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Using donor eggs or sperm

I've used donated eggs/sperm in my IVF treatment.  How do I find out more about the donor?
If you have had treatment using donated sperm or eggs in a UK clinic, the HFEA will hold information about the donor on the HFEA Register.  The amount of information available will depend on when your treatment took place. 

For more information see The HFEA Register - information for parents of donor-conceived children.

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I may have to use donated eggs or sperm in my treatment - what are the rules about this?
If your clinic recommends using donated eggs or sperm, it is usually because they consider that treatment would be unlikely to be successful if you were to use your own eggs or sperm.  Before going down this route, there are some complex issues you may want to consider and talk through with an experienced counsellor.  One key issue is what you will tell your children about their conception.

For more information, see our leaflet on Using donated eggs, sperm or embryos in your treatment.

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I am using donor sperm in my treatment.  Whose name goes on the birth certificate as the baby's father?
If you are being treated together with your husband or partner at a HFEA licensed clinic, his name will go on the birth certificate, provided that he has consented to the treatment.  If you are in a same-sex partnership it is not possible to register your partner's name on the birth certificate.

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I hear there's a shortage of sperm donors in the UK. Can I buy sperm from abroad?
Some clinics are currently finding it difficult to find sperm from UK donors to treat their patients. Waiting lists for donor sperm can be long and some clinics may suggest that you buy sperm from an overseas sperm bank to use instead.  There are various issues you should consider before going ahead. 

See our factsheet, Importing donor sperm, for more information.

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Can I use fresh sperm from internet websites? Is it legal? Is it safe?
The law states that no-one can 'procure, test, process or distribute' eggs or sperm to be used for human application without their activities being covered by a licence from the HFEA. This includes organisations controlling the supply or transport of sperm or eggs.

For people using unlicensed services, there are also serious implications regarding who is legally the father of any child conceived. The law says that men donating sperm through HFEA licensed fertility clinics are not the legal father of any child born through that donation. This includes cases where the donor is known to the recipient.

Men giving out their sperm in any other way - such as via internet services or private arrangements with people they know - are legally the father of any children born with all the responsibilities that carries.

The HFEA recommend that people seeking to donate sperm or to be treated using donated sperm do so only through the UK's licensed clinics. This includes cases where the donor is known to the recipient. People using licensed clinics can be sure that any donor sperm or eggs used in their treatment has been subject to rigorous quality checks, including screening to ensure that the material has not been infected with diseases such as Chlamydia or HIV. Patients using unlicensed services do so at their own risk.

We have been in discussion with internet sperm companies, and their predecessors since 2006 to warn them that they would need to have a licence from the HFEA if they were to continue to operate after 5 July 2007. None of these companies has completed applications to the HFEA in an attempt to get a licence.

Since 5 July we have written to UK internet sperm companies stressing to them that distributing or procuring eggs or sperm without a licence from the HFEA is a criminal offence.

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I´ve seen press reports saying that only anonymous sperm donors are exempt from being treated as the legal father - is this true?
No - if you donate sperm at a HFEA licensed clinic, even where you are known to the recipient, you cannot be treated as the legal father of any children born as a result of that donation.